Targeting the virus–host interface for the development of therapeutics against filoviruses

Until relatively recently, treatment for filovirus infections was limited to supportive care measures, but the occurrence of several large outbreaks in past years, including a multinational epidemic in West Africa from 2013 to 2016, has spurred the advancement of several therapeutic approaches into clinical trials, and even led to the recent licensure of two monoclonal antibody-based therapies against the Ebola virus. However, there are still significant gaps in our preparedness, in particular with respect to our ability to treat infections with other filoviruses, such as Marburg virus and Sudan virus. To address this, continuing research is focused on both leveraging what we have learned from these recent successes treating Ebola virus disease and exploring novel approaches for the management of filovirus infections. One promising approach toward the development of broad-spectrum therapeutics is focused on targeting the virus-host interface rather than directly targeting the virus itself. This review summarizes the currently licensed treatments, discusses current gaps, and highlights promising new directions in antiviral therapy both for EBOV and other filoviruses.